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Ambulances key part of trauma tangle

ATLANTA - When a state panel divvied up almost $59 million in state funding to help Georgia's beleaguered trauma-care system, hospitals like Memorial University Medical Center in Savannah that handle treatment of the most critically injured patients weren't the only ones getting assistance.

Almost $6.5 million went to providers of emergency transportation services, highlighting what some observers believe is a segment of the trauma-care problem often overlooked by the public: how to get patients to trauma centers.

Ben Hinson, a member of the Georgia Trauma Care Network Commission and owner of Mid Georgia Ambulance Service, noted that the panel had set aside funding to make sure trauma-care centers could afford to have doctors and equipment ready for an emergency.

"Well, if there are no paramedics out there waiting to respond on a second's notice, you won't need the doctors," Hinson said.

Indeed, ambulances are a crucial part of efforts to make sure every Georgian is within an hour of a trauma center, supporters say. Getting the state's trauma fatality rate down to the national average would save more than 700 lives a year, according to some estimates.

"The 'Golden Hour' is the hour that can make a difference in 700 lives a year, and if that's not adequately supported, if there are rural Georgians that are compromised by virtue of not having access to a trauma center within that golden period of time, then we certainly need to do something about that," said Healthcare Georgia Foundation President Dr. Gary Nelson.

Spiraling fuel prices have not helped the situation, especially with almost all of the state's ambulances running on diesel fuel. Hinson said his weekly fuel costs are up as much as $4,500 a week.

The trauma commission set aside about $1.5 million to help cover the emergency medical service bills of patients who can't pay themselves.

Nearly $1 million is devoted to a program that would add GPS equipment to some ambulances, helping drivers with directions and providing emergency coordinators with real-time information on where ambulances are.

Another $4 million went to a grant program to help purchase new ambulances.

"We've got ambulances out there with 300,000 and 400,000 miles on them," said Courtney Terwilliger, chairman of the Georgia Association of Emergency Medical Services and EMS director in Emanuel County. "And those concern us and, in many situations, those are the ambulances that are in those rural counties that are driving 100 miles to a trauma center."

Meanwhile, the trauma commission might try to get a better handle on the costs of trauma to EMS providers. Those could be hard to do; many patients are taken by ambulance to hospitals that aren't trauma centers by a hodgepodge of EMS providers, which include private companies, fire departments and hospitals themselves.

"Getting data - good, hard, clean data - on what is going on across the state has been very difficult," Terwilliger said.